Affiliation:
1. Department of Emergency and Critical Care Medicine Saiseikai Utsunomiya Hospital Utsunomiya Japan
2. Department of Emergency Medicine National Hospital Organization Mito Medical Center Mito Japan
Abstract
AbstractBackgroundCalcium channel blockers and angiotensin II receptor blockers are commonly prescribed to treat hypertension. Massive overdoses can cause both distributive and cardiogenic shock because of their effects on vascular smooth muscles and severe myocardial depression.Case PresentationWe present the case of a 46‐year‐old man who was brought to our emergency department after ingesting 1210 mg amlodipine and 936 mg candesartan. The patient's hemodynamic status deteriorated despite treatment with vasopressors, calcium gluconate, and hyperinsulinemia‐euglycemia therapy with mechanical ventilation. Venoarterial extracorporeal membrane oxygenation was initiated for refractory shock. The patient was weaned off extracorporeal membrane oxygenation on day 5 and discharged on day 18 of hospitalization.ConclusionWhen medical therapies are ineffective, aggressive venoarterial extracorporeal membrane oxygenation should be considered for the management of refractory shock in the setting of calcium channel blocker with angiotensin II receptor blocker overdose.
Subject
Industrial and Manufacturing Engineering,Materials Science (miscellaneous),Business and International Management
Cited by
2 articles.
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